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Role of community pharmacists in the safe and effective use of complementary and alternative medicine in the Middle East: A scoping review
Background Community pharmacists (CPs) play a crucial role in promoting safe use of Complementary and Alternative Medicine (CAM). This scoping review examined existing evidence on the role of CPs in CAM in the Middle East, a region harboring one of the fastest growing markets of CAM. Methods A comprehensive search of nine electronic databases was conducted to identify relevant studies published between 2000 and 2025. A total of 155 studies met the inclusion criteria. Key study characteristics were extracted using a standardized data extraction form. Thematic analysis of findings and recommendations was carried out using NVivo software to identify common patterns, themes, and gaps in the literature. Results The studies primarily used quantitative cross-sectional designs and were predominantly led by academic institutions. International and regional collaborations were scarce. Over the past 25 years, there has been a notable rise in the annual number of published papers; however, this upward trend was not reflected in the impact factors of the journals in which these papers appeared. The thematic analysis revealed three main themes: (1) Opportunities, including pharmacists’ positive attitudes and willingness to take on active roles in CAM; (2) Challenges, such as knowledge gaps, poor reporting practices, logistical barriers to counseling, weak regulatory oversight, and misinformation driven by media; and (3) Recommendations, targeting improvements in practice, education, and policy. Conclusions The review findings suggest the need for studies to diversify their designs and strengthen cross-sector collaborations. To enhance CPs’ role in ensuring the safe use of CAM, coordinated, evidence-based strategies are required. These should integrate professional development, regulatory reform, and targeted public education, ultimately supporting CPs in delivering informed, patient-centered CAM services.
Spatial control of curing kinetics in thiol-ene-systems through antagonistic photoreactions
Ground state and dynamics of one-dimensional quantum droplets
Immediate improvement in anxiety and sleep quality with delayed depression response after bariatric surgery in a longitudinal cohort study
Evaluating the cost-effectiveness of COVID-19 mRNA primary-series vaccination in Qatar: An integrated epidemiological and economic analysis
Qatar implemented a mass primary-series vaccination campaign to mitigate the impact of the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to retrospectively evaluate the cost-effectiveness of this program both before and after onset of the omicron wave. An economic evaluation was conducted from the public healthcare system perspective between January 5, 2021, and September 18, 2023. Cost-effectiveness was determined using an epidemiological retrospective cohort study and health economic modeling that compared the cohort of individuals who received two vaccine doses with the unvaccinated cohort with respect to incidence of infection, incidence of severe COVID-19 forms, quality-adjusted life years (QALYs), and medical costs. During the pre-omicron phase, primary-series vaccination incurred an additional cost of $104,422,358, led to a gain of 724.7 QALYs, and savings of $54,790,858 in direct medical costs. The incremental cost-effectiveness ratio (ICER) was $68,485 per QALY gained. The number needed to vaccinate was 35.4 individuals (95% CI: 24.4–49.9) to prevent one infection and 718.0 individuals (95% CI: 469.4–984.0) to prevent one severe COVID-19 outcome. The cost per infection averted was $3,180 (95% CI: $2,189-$4,484) and per severe COVID-19 outcome averted was $64,468 (95% CI: $42,146-$88,354). Vaccination of individuals ≥50 years of age, those more clinically vulnerable to severe COVID-19, and those with multiple coexisting conditions was substantially more cost-effective. Cost-effectiveness of primary-series vaccination was substantially reduced during the omicron phase, but vaccination remained cost-effective. Sensitivity analyses confirmed the findings. Primary-series vaccination was cost-effective with an ICER below the 1 GDP per capita threshold during the pre-omicron phase and within the 1–3 GDP per capita thresholds during the omicron phase. Targeted vaccination strategies for those most vulnerable to COVID-19 were the most cost-effective and remained essential, even in situations of moderate vaccine effectiveness or reduced infection severity.
Episomal and integrated hepatitis B transcriptome mapping uncovers heterogeneity with the potential for drug-resistance
Abstract Hepatitis B virus (HBV) is a small DNA virus that establishes chronic infection and drives progressive liver disease and cancer; presenting a global health problem with more than 250 million infections. HBV replicates via an episomal covalently-closed-circular DNA (cccDNA) and integrated viral DNA fragments are linked to carcinogenesis. Current treatments only suppress HBV replication and there is a global initiative to develop genome targeting therapies, including siRNAs, antisense oligonucleotides and epigenetic modifiers specific for HBV cccDNA. However, our knowledge of the cccDNA and integrant transcriptomes is confounded by overlapping viral RNAs. Using targeted long-read sequencing we mapped the HBV transcriptome in liver biopsies from eleven treatment naïve patients. Probe enrichment yielded robust sequencing libraries and identified cccDNA-derived genomic and sub-genomic transcripts, and a repertoire of previously uncharacterised spliced, truncated and chimeric viral RNAs. Assigning viral transcripts to their respective DNA templates revealed differential promoter activity in cccDNA and integrants, with implications for the efficacy of epigenetic modifiers. Integrant-derived transcripts showed vast diversity in the viral-host junctions, posing a challenge for current nucleotide-targeting therapies. cccDNA was a source of genetic polymorphism, with distinct viral lineages present in the surface antigen encoding region, providing an insight into hepadnavirus evolution during chronic infection.
Research on intelligent regulation of layered water injection based on reinforcement learning SAC algorithm
Online exam cheating detection and blockchain trusted deposit based on YOLOv12
Cost-effectiveness analysis of benmelstobart and anlotinib plus chemotherapy versus standard chemotherapy in first-line treatment for extensive-stage small cell lung cancer: Perspectives from the United States and China
Background Benmelstobart combined with anlotinib and chemotherapy has demonstrated significant clinical advantages in extending progression-free survival and overall survival compared to chemotherapy alone in patients with extensive-stage small-cell lung cancer (ES-SCLC). This is the first study to assess its cost-effectiveness from both the US payer and Chinese healthcare system perspectives. Method A Markov state-transition model was utilized for the economic evaluation, reflecting both the perspectives of the US payer and the Chinese healthcare system. Baseline patient demographics and vital clinical data were obtained from the ETER701 trial. Costs and utilities were obtained from open-access databases and published literature. The primary outcomes evaluated were quality-adjusted life years (QALYs), incremental cost-effectiveness ratio (ICER), incremental net health benefit (INHB), and incremental net monetary benefit (INMB). The uncertainties of the model were addressed through probabilistic sensitivity analysis, one-way sensitivity analysis, and scenario analysis. Results In the base-case scenario, adding benmelstobart and anlotinib to chemotherapy increased QALYs by 0.34 at an additional cost of $24,684.07, yielding an ICER of $71,559.84 per QALY. This exceeds the willingness-to-pay (WTP) threshold of $38,042.49 per QALY in China, making the treatment marginally cost-effective, with an INHB of −0.30 QALYs and an INMB of -$11,561.58. In the US, the treatment resulted in a QALY increase of 0.36, but incurred an additional cost of $151,052.04, leading to an ICER of $416,398.56 per QALY, surpassing the US WTP threshold of $150,000. 00. Conclusion The combination of benmelstobart and anlotinib with chemotherapy is not a cost-effective first-line treatment option for ES-SCLC in either China or the US.
Versatile polymer-coated Ag2Se thermoelectric materials and devices for multi-scenario applications developed by direct-ink printing
The impact of nutritional information intervention on farmers’ adoption of selenium-enriched agricultural crop cultivation techniques
Unveiling the real-time behaviour of Staphylococcus aureus through nanomotion sensing
Regulatory influence of α-Pinene on MATN3 expression in hepatocellular carcinoma: Extending to pan-cancer analysis
In the search for novel therapeutic strategies against cancer, natural compounds such as α-Pinene, a bioactive monoterpene predominantly found in coniferous trees, have emerged as potential modulators of oncogenic processes. The primary objective of this study was to investigate whether α-Pinene can regulate the expression of MATN3 (Matrilin-3), a gene previously associated with poor prognosis in various cancers. Our central hypothesis is that α-Pinene exerts its anticancer effects, at least in part, by downregulating MATN3, thereby impacting oncogenic signaling. The rationale for selecting MATN3 as a target lies in its demonstrated overexpression in multiple cancer types and its established role as both a prognostic marker and a contributor to tumor progression. Extending our research through a comprehensive pan-cancer analysis, we confirmed the association between high MATN3 expression and poor prognosis across multiple cancer types. Further exploration revealed a strong correlation between MATN3 expression and immune infiltration, as well as significant associations with key immunomodulatory genes, suggesting an intricate role of MATN3 in the tumor immune environment. Enrichment analysis pointed to the involvement of MATN3 in the PI3K-AKT signaling pathway. Additionally, we identified connections between MATN3 and extracellular matrix (ECM)-related mechanisms.The downregulation of MATN3 by α-Pinene in HepG2 cells suggests a novel mechanism by which α-Pinene may exert anticancer effects, potentially through the disruption of key oncogenic and immune-related pathways. This study not only underscores the anticancer potential of α-Pinene but also establishes MATN3 as a critical target and biomarker across a spectrum of cancers. Our findings advocate for further clinical investigations into α-Pinene’s therapeutic potential, particularly focusing on its impact on MATN3 and related pathways in diverse cancer contexts.
DNA2 and MSH2 cooperatively repair stabilized G4 and allow efficient telomere replication
Abstract G-quadruplexes (G4s) are widely existing stable DNA secondary structures in mammalian cells. A long-standing hypothesis is that timely resolution of G4s is needed for efficient and faithful DNA replication. In vitro, G4s may be unwound by helicases or alternatively resolved via DNA2 nuclease mediated G4 cleavage. However, little is known about the biological significance and regulatory mechanism of the DNA2-mediated G4 removal pathway. Here, we report that DNA2 deficiency or its chemical inhibition leads to a significant accumulation of G4s and stalled replication forks at telomeres, which is demonstrated by a high-resolution technology: Single molecular analysis of replicating DNA (SMARD). We further identify that the DNA repair complex MutSα (MSH2-MSH6) binds G4s and stimulates G4 resolution via DNA2-mediated G4 excision. MSH2 deficiency, like DNA2 deficiency or inhibition, causes G4 accumulation and defective telomere replication. Meanwhile, G4-stabilizing environmental compounds block G4 unwinding by helicases but not G4 cleavage by DNA2. Consequently, G4 stabilizers impair telomere replication and cause telomere instabilities, especially in cells deficient in DNA2 or MSH2.
Four-limb CFST latticed columns seismic performance: experimental and ANN predictions
Long term monitoring shows phase lagged behaviorally driven locomotor autonomic coupling
Unlocking insights from complex data: Leveraging heat maps for decision-making in LMIC
Introduction In low- and middle-income countries (LMICs), health outcomes are often constrained by inadequate or misdirected resource allocation and limited access to services such as contraception and immunization. We explore the use of spatial heat maps to analyze the stock availability and dispensation/vaccination patterns of contraceptives and vaccines in Pakistan. Methods We used data from national contraceptive (cLMIS) and vaccine logistics management information systems (vLMIS). We applied univariate, bivariate, and trivariate spatial heat maps to assess contraceptive and vaccine stock levels, dispensation/vaccination, and wastage across districts. For contraception, we standardized stocks per 100,000 married women of reproductive age (MWRA) and dispensation rates. In immunization, we focused on Pentavalent-3 (Penta3) vaccine outreach, dropout rates, and Bacillus Calmette–Guérin (BCG) vaccine wastage. Results Temporal and spatial variations highlighted regional disparities, revealing that developed regions like Punjab had better stock availability, while underserved areas like Balochistan faced higher dispensation rates and stockouts. We also show the effect of inputs (supplies, outreach) on dispensation and utilization of contraceptives and vaccines, respectively. Finally, we depict how these visualizations can help track changes in programming over time. Conclusions Our findings show that integrating spatial data visualization with health logistics data identifies critical gaps in health service supply and demand, guiding policymakers in resource allocation, stock management, and service outreach. This scalable approach suits systems with limited analytical resources, as many analyses can be automated and embedded in datasets, providing policymakers with a focused set of visualizations for interpretation, avoiding the need for extensive training or deploying analysis teams at local levels. By leveraging spatial and temporal data, this method supports efficient health system strengthening and resource allocation in LMIC.
Recombination of localized quasiparticles in disordered superconductors
Physiotherapist assisted wrist movement protocol for EEG-based corticokinematic coherence assessment
Abstract This study aimed to assess the feasibility of a physiotherapist-assisted wrist-movement protocol to measure corticokinematic coherence (CKC) using electroencephalography (EEG) in healthy adults. The broader goal is to evaluate CKC’s potential as a proprioceptive assessment tool in clinical settings. Thirty-two healthy young adults participated in a hand movement task, in which a physiotherapist periodically moved their hand by relying on a “visual metronome”. We measured CKC by co-recording EEG and hand acceleration data. CKC was observed at the fundamental movement frequency and its first harmonic, mainly at electrodes above the primary sensorimotor area contralateral to the moved hand. The use of a visual metronome helped to maintain the regularity of the movement, but slight between-hand differences in movement regularity were nonetheless present. The results support the feasibility of using a physiotherapist-assisted, wrist-movement-based EEG protocol to assess CKC. This method holds promise for evaluating proprioceptive function in clinical populations, as it enables tailoring the movement to individual needs and real-time adaptation to physiological variability in a natural physiotherapist-patient interaction without requiring a mechanical actuator. The findings lay the groundwork for future applications in stroke rehabilitation and other neurological contexts.